Priors Mead Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. For example, the registered manager acknowledged that in the past, recording was not always effective. They told us, “The staff have improved a lot since. If it is not written, it did not happen. I have so many staff who go above and beyond, but if they don’t record this, nobody knows.”

The provider had procedures for dealing with incidents, accidents and complaints. The management team investigated these and developed plans for improvements. These were shared with the staff. The staff confirmed the registered manager discussed adverse events with them so they could learn together. Relatives we spoke with told us they were well informed when things went wrong, and they were confident improvements were made as a result.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services, for example if they required a hospital admission. They supplied summaries of key information about people’s communication and healthcare needs to help ensure everyone involved in their care had the information they needed.

The provider carried out thorough assessments of people’s needs, consulting with the person, their representatives and other professionals involved in their care.

People told us the staff were always available if they needed support. Relatives stated they were informed and involved when their family members required support or treatment from different services.

External healthcare professionals involved in the service provided information and training sessions to enhance the staff’s skills and knowledge.

The service had up to date policies and procedures in place. Staff were required to read, understand and follow these.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider had procedures to help safeguard people from the risk of abuse. People using the service told us they felt safe. Their comments included, “I feel safe, yes”, “All is safe, I have no problems” and “I do feel safe, I cannot think of anything that is concerning. I can get up and go to where I want, when I want.” The provider worked with the local authority and other organisations to help investigate allegations of abuse and to keep people safe.

The provider had requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People said staff knew their needs and met these safely. They said staff were responsive and answered their call bells promptly. Processes to help ensure risks to people were assessed and mitigated were effective. Overall, we observed safe care being delivered to people.

The registered manager reviewed each incident or accident to establish the cause, and what actions were needed to reduce the risk of re-occurrence. When people could become distressed, there was guidance to inform staff how to support them to de-escalate or reduce their anxiety.

There were effective systems to review care plans and ensure they were sufficiently detailed and contained key information and guidance for staff.

Personal emergency evacuation plans were in place for each person. These contained detailed information about each person and the support they required to safely evacuate the building in the event of a fire or other emergency.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were supported in a safe and well-maintained environment that met their needs. People told us they liked the home and felt it was homely and comfortable.

During a recent inspection by the Food Standards Agency, some shortfalls were identified. The registered manager showed evidence these shortfalls had been addressed without delay. During our visit, we found the kitchen to be clean and well organised. Staff wore appropriate uniform and protective wear. Fridges were clean and food items stored correctly. All checks were carried out regularly. The laundry was well organised, and staff followed correct infection control procedures.

There were effective systems in place to monitor and regularly check the safety and upkeep of the premises. The registered manager and staff worked together to help ensure any potential risks were identified and addressed promptly such as faulty equipment or trip hazards. There was a maintenance staff member available whenever any repairs were necessary. There were regular checks of all areas of the home to ensure safe systems were in place. These included water temperatures, fire safety checks and kitchen equipment.

Equipment used to support people was suitable, well maintained and stored securely. The provider had an up-to-date plan in place to help ensure people were supported in the event of an emergency.

The home was clean and well-maintained with good fixtures and furnishings. Communal areas were light and airy which allowed people to mobilise easily. People’s bedrooms were personalised with photographs and items belonging to them.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Most people we spoke with said there were enough staff to meet their needs. However, one person told us, “There are too few staff here. The whole place is understaffed.” We checked the staff rota for the previous 4 weeks and found that although all the shifts were adequately covered, the provider relied on agency staff to cover some shifts. We discussed this with the registered manager who told us, “We are using agency staff at the moment. We ensure we use the same 3 workers from 2 agencies to help ensure we have continuity.” One person added they never knew which staff members were on duty. They told us, “I don’t ever know who is on duty. A couple are very good but really I think each person should have the same one or two.” We fed this back to the registered manager who said they would address this.

The registered manager did not use a dependency tool to evaluate the number of staff required to meet people’s needs. However, they explained, “Because I know the residents well, we know when people’s needs change. If they have additional needs, we discuss these with my managers and decide if we need additional staff. We look at notes and staff feedback and get the feel of the home, for example more incidents, and I know we need more staff.” They gave an example and said, “When [Person] returned from hospital [they] appeared to have delirium, slept during the day and awake at night. We spoke with the family and my managers and decided to have an additional carer at night every night.”

The provider’s systems helped make sure staff were suitable when recruited. They carried out pre-employment checks and provided an induction, assessed staff competencies at work and provided a range of training.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People told us they felt safe from the risk of infection because premises and equipment were kept clean and hygienic. One person told us, “The home is always clean.” The home was clean, tidy and well-maintained. Bathrooms and toilets were modern and large, and fully accessible. There was a cleaning person on duty daily and cleaning schedules were in place to ensure the home was kept to a high standard.

The staff received training in infection control and followed safe guidelines. Care staff wore appropriate PPE when supporting people to help protect them from cross infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their medicines safely and as prescribed. One person told us, “I have to take eye drops regularly and take a pill for my blood pressure. I think the medicines administration and application here is impressive and organized. It is always well done and managed.”

Medicines were kept in a locked cupboard disguised as a bookshelf. This was to make sure that the environment still felt homely rather than institutional. All information about each person was kept in a folder. This included their allergy status, particularly in terms of medicines reactions, any dietary needs and cultural needs. There was information about staff authorised to administer medicines. This included their names, initials and signatures. This was regularly reviewed and updated.

Each person had a basic information sheet in place which had their recent photograph. Where people were prescribed ‘as required’ medicines (PRN), there were protocols in place and these were clear and comprehensive. They included details of the person, the name of the medicine, dosage and frequency, purpose of administration and possible side effects and possible interactions from other medicines.

Medicines were kept in their original packages. These listed the prescriber’s instructions and medicines administration record (MAR) charts reflected these. Each pack had the date of opening, and this meant the staff could check daily if the number of tablets left in the packs were correct. We checked the MAR charts for 10 people and saw there were no errors, and the staff signatures corresponded to the amount of tablets given.

Controlled drugs were kept in a locked cabinet inside the locked cupboard. We saw the controlled drugs register was clear and appropriately signed by two staff. There were no errors.

Staff recorded the temperature of the medicines store three times a day, and these were within safe range.